Interrelationship Between Celiac Disease, Self-Reported Wheat Sensitivity, and Functional GI Disorders

Individuals with clinically diagnosed celiac disease have a greater rate of functional dyspepsia, a gastrointestinal disorder highly correlated with wheat sensitivity, according to a study published in The American Journal of Gastroenterology.

Michael D. E. Potter, MBBS (Hons), of the University of Newcastle in New South Wales, Australia, and colleagues conducted a population-based group analysis to compare self-reported gluten sensitivity, physician-diagnosed celiac disease, and functional gastrointestinal disorders or symptoms. 

Self-reported wheat sensitivity was defined as gastrointestinal symptoms upon consumption of wheat-based foods reported by an individual with no history of celiac disease, inflammatory bowel disease, or colorectal cancer. 

The investigators released a survey to randomly selected individuals of Australia; the survey included questions regarding wheat sensitivity, gastrointestinal symptoms, demographic information, and factors contributing to health and lifestyle.

A total of 3542 people responded to the survey, and 3115 completed all components; 14.9% self-reported wheat sensitivity, 10.8% of whom had also been diagnosed by their physician as having gluten or wheat intolerance. A diagnosis of celiac disease was reported in 1.2% of the population. For individuals with clinically diagnosed celiac disease, the odds of additional diagnosis of functional dyspepsia and irritable bowel syndrome were significantly greater compared with those nonaffected (odds ratio [OR], 3.35 and 2.28, respectively). Self-reported wheat sensitivity was independently correlated with irritable bowel syndrome and functional dyspepsia according to a multivariate test (OR, 3.55 and 1.48, respectively).

“Self-reported wheat sensitivity is common, with a prevalence of 14.9% in this cohort,” the authors wrote. “There is a strong association between both celiac disease and self-reported wheat sensitivity, and chronic gastrointestinal symptoms, as well as a diagnosis of [functional dyspepsia] and [irritable bowel syndrome].”

Potter MDE, Walker MM, Jones MP, Koloski NA, Keely Sm, Talley NJ. Wheat intolerance and chronic gastrointestinal symptoms in an Australian population-based study: association between wheat sensitivity, celiac disease, and functional gastrointestinal disorders [published online June 19, 2018]. Am J Gastroenterol. doi.org/10.1038/s41395-018-0095-7

From the September 01, 2018 Issue of Clinical Advisor